Aluminum and zinc phosphides are effective, cheap and available rodenticides and insecticides known to have high mortality rats. Exposure to these compounds occurs suicidal, accidental or occupational. Aim: The current work was performed to compare the ability of Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Simplified Acute Physiology Score II (SAPS II) to predict mortality of acute aluminum and zinc phosphide poisoned patients admitted to ICU. Subjects and methods: Patients admitted to ICU from January 2015 to December 2015 were included and prospectively followed up till discharge or death where they were divided into survivors and non- survivors groups. The socio-demographic and poisoning data were collected and SOFA, APACHE II and SAPS II scores were calculated during the first twenty four hours post admission. The accuracy of each scoring system was detected using Receiver Operating Characteristic (ROC) curve analysis and standardized mortality ratio (SMR) and by means of Hosmer & Lemeshow goodness-of-fit test. Results: sixty two patients were enrolled, the overall mortality rate was 30.6%; higher mortality rate was associated with aluminum phosphide, delayed time to ICU admission and with suicidal exposure. SOFA, APACHE II, SAPS II values were significantly higher in non- survivor group. SOFA shows significantly higher AUC 0.981 versus 0.856 for APACHE II and 0.837 for SAPS II, the SMR of SOFA was 1.18. Conclusion: although SOFA, APACHE II and SAPS II can predict mortality of acute aluminum and zinc phosphide patients admitted to ICU, SOFA score has the highest predictive values besides being easier and simpler.